7. Examine the female genital tract, remove the peritoneum overlying the ovarian vessels.
Observe the relationships of the pelvic organs of the female: the pubic symphysis, the urinary bladder, the urethra extending inferiorly, the vagina, the uterus, the uterine tube, ovary. Here is the rectum leading to the anal canal. The peritoneum is divided into spaces by the uterus. Between the bladder and uterus is the vesicouterine pouch. Between the uterus and rectum is the rectouterine pouch. Beneath the peritoneum in the lateral wall, trace the course of the ureter down the posterior pelvic wall, across the cervix and into the back of the bladder. Anteriorly, note the suspensory ligament of the ovary containing the ovarian vessels. Coming from the uterus anteriorly within the broad ligament and across the pelvic wall, is the round ligament of the uterus. Here it passes through the deep inguinal ring. Once again review the parts of the broad ligament. Below the uterine tube, the mesosalpinx. Projecting posteriorly from the mesosalpinx and extending a short distance to the ovary is the mesovarium. In its free border, the ovarian ligament, which is continuous with the round ligament of the uterus. The anterior portion of the broad ligament attaching to the uterus is the mesometrium, crossed by the round ligament. Next, turn your attention to the ovary and the suspensory ligament of the ovary that contains the ovarian vessels and nerves. Note the ureter, heading down the posterior pelvic wall across the cervix to the trigone of the bladder. Between the ligament and the ureter there is a depressed space containing the ovary, the ovarian fossa. Now turn your attention to the uterine tube. It extends between the fundus of the uterus and the ovary. The narrowest portion, attached to the uterus, is the isthmus. Laterally, the tube expands into the ampulla. The tube ends in a funnel shaped infundibulum. Projecting from the infundibulum, are the fimbrae. The fimbrae radiate from the opening of the uterine tube, the external os. Next, observe the suspensory ligament of the ovary and its contents. Here is the ovary, the fimbrae, and the suspensory ligament. Within the ligament, note the coiled ovarian ligament surrounded by the ovarian veins. Observe the parts of the uterus: the fundus, the body, neck, the cervix, its extension into the vagina, the cervical canal, continuous with the lumen of the body of the uterus. Next, note the position of the uterus. Normally the uterus is folded anteriorly on the back of the bladder and is termed anteverted. The uterus is also anteflexed or bent, due to the angle made by the junction of the cervix and the uterus. Below the uterus, observe the vagina. It opens into the vestibule of the vagina and extends posteriorly and superiorly. Penetrating its anterior wall is the intravaginal portion of the uterine cervix. It is surrounded by a groove called the fornix. The opening of the uterus into the vagina is called the external ostium of the uterus. Note the relationship of the posterior fornix to the rectouterine pouch where the wall is very thin.
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